Do single handed practices offer poorer care? Cross sectional survey of processes and outcomes

Objectives To determine whether there are important differences in performa nce between group practices and singlehanded general practitioners and the extent to which any differences are explained by practice characteristics s uch as deprivation. Design Cross sectional survey. Setting 206 singlehanded practices and 606 partnerships in Trent region, Un ited Kingdom. Method Comparison of process and outcome measures derived from routinely co llected data on hospital admissions and target payments for singlehanded pr actices and partnerships. Multivariate analysis was used to adjust for the confounding effects of general practice characteristics-deprivation (Townse nd score), percentage of Asian residents, percentage of black residents, pr oportion of men over 75 years, proportion of women over 75 years, rurality, presence of a female general practitioner, and vocational training status. Results Differences in achievement of immunisation and cytology targets app arent on univariate analysis were not seen after adjustment for other gener al practice characteristics. Similarly, significant differences (> 15%; P < 0.01) for three types of hospital admission seen on univariate analysis we re not present after adjustment for other practice characteristics. Conclusions This study provides no evidence that singlehanded general pract itioners are underperforming clinically. Our results offer insight into the structural difference between the two types of practice and underline the importance of the effect of other practice characteristics on process and o utcome measures.